Abstract
BackgroundThe aim of this study was to assess whether partially absorbable monofilament mesh could influence postoperative pain and recurrence after Lichtenstein hernioplasty over the long term.MethodsPatients were randomized into two groups that were treated with lightweight (LW) or heavyweight (HW) mesh in 15 centers in Poland. A modified suture technique was used in the lightweight mesh group. Clinical examination was performed. A pain questionnaire was completed five years after the surgery.ResultsOf the 392 patients who underwent surgery, 161 (90.81 %) of 177 in the HW group and 195 (90.69 %) of 215 in the LW group were examined according to protocol, a median of 62 (range 57–66) months after hernia repair. There was no difference in the recurrence rate (1.9 % LW vs. 0.6 % HW; P = 0.493). There were 24 deaths in the follow-up period, but these had no connection to the surgery. The patients treated with LW mesh reported less pain in the early postoperative period. After five years of follow-up, the intensity and the presence of pain did not differ between groups (5 patients in the LW and 4 patients in the HW group). Average pain, (VAS score), was also similar in the LW and HW group (2.25 vs. 2.4) at the fifth year postoperatively.ConclusionThe use of partially absorbable mesh reduced postoperative pain during the short-term postoperative period. No difference in pain or recurrence rate was observed at 60 months.
Highlights
Tension-free mesh repair currently represents the gold standard in inguinal hernia surgery [1]
Background The aim of this study was to assess whether partially absorbable monofilament mesh could influence postoperative pain and recurrence after Lichtenstein hernioplasty over the long term
No difference in pain or recurrence rate was observed at 60 months
Summary
Tension-free mesh repair currently represents the gold standard in inguinal hernia surgery [1]. Meshes built of dense woven propylene, the substance most commonly used in the production of prosthetic materials in hernia surgery, are characterized by low biocompatibility [3] This feature induces a potent immunologic response from the surrounding tissue, which may lead to the development of chronic pain, which was assessed in many trials to be present in more than 20 % of patients [4]. Efforts to address this problem over the last decade have led to the technological development of a new generation of lightweight meshes. The aim of this study was to assess whether partially absorbable monofilament mesh could influence postoperative pain and recurrence after Lichtenstein hernioplasty over the long term
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